Clinical scenario: Specialty Training Interview Questions

The clinical station is the heart of most training interviews. Scenarios are acute and generic at core level and specialty specific at ST3, usually in two parts: the call, then what you find. Several specialties give the scenario in advance with reading time.

Updated 26 October 2026

How to answer

Go to see the patient, assess with ABCDE, treat what can be treated, escalate early and clearly, and say what you would do afterwards. Assessors are scoring judgement, prioritisation and escalation rather than knowledge; a safe answer that asks for help early beats a clever one that does not.

Frameworks: SAFER, with ABCDE inside Assess and SBAR for the handover at Escalate

  • SAFER See the patient, Assess systematically with ABCDE, Fix what you can and decide, Escalate with a clear request in SBAR or ISBAR, Review: the patient told, the handover, the documentation and what you would do if the first plan failed. Full guide →
  1. Asked in most interviewsUsually asked by the clinical director or clinical leadSAFER

    You are the SHO on call. A ward nurse fast bleeps you because a patient has vomited a large volume of fresh red blood. Describe how you would approach this.

    • Follow-up: The blood pressure is 85 systolic and the patient is drowsy. What now?

    ABCDE, oxygen, two large bore cannulas, bloods and crossmatch, fluids and then blood, stop anticoagulants, call the registrar early and the gastroenterology and anaesthetic teams, and keep the nurse and the patient informed. When the pressure is 80 and he is drowsy, it is a major haemorrhage call and the senior comes now.

  2. Asked in most interviewsUsually asked by the clinical director or clinical leadSAFER

    You are asked to review a patient two days after surgery who is breathless with a fast pulse. Talk us through your approach.

    • Follow-up: Who do you call, and what do you tell them?

    ABCDE, oxygen, observations and their trend, examine the chest and the legs, ECG, bloods and a gas, chest imaging, treat what you find, and think of the embolus, the pneumonia and the bleed. Escalate with SBAR and say what you want the registrar to do.

  3. Asked in most interviewsUsually asked by the clinical director or clinical leadSAFER

    A patient on the ward collapses and you are the first doctor there. What do you do?

    Call for help and the arrest trolley, check responsiveness and breathing, start chest compressions if there is no pulse, follow the algorithm, delegate roles as the team arrives, and hand over to the team leader. Afterwards, the family, the documentation and the debrief.

  4. Often askedUsually asked by the consultant colleague in the specialtySAFER

    You are managing a deteriorating patient and the registrar is not answering. What do you do?

    Keep treating with ABCDE, bleep again and use the switchboard to find the registrar, and escalate past them: the consultant on call, the critical care outreach team, or an arrest call if the patient is peri arrest. Say what you would do about the unanswered bleep afterwards.

  5. Often askedUsually asked by the clinical director or clinical leadSAFER

    A patient becomes agitated and wants to leave against advice. How do you handle it?

    Assess capacity, find out why they want to go, address what can be addressed, explain the risks plainly, involve a senior, and if they have capacity and still leave, make it as safe as possible and document. If they lack capacity, the law allows you to keep them safe. Never physically restrain alone.

  6. Often askedUsually asked by the consultant colleague in the specialtySAFER

    You have three unwell patients and one of you. How do you prioritise?

    Triage by acuity using the observations, see the sickest first, delegate the simple tasks to the nurses, and escalate early for help with the others. Say what you would ask each person to do and when you would review the other two.

  7. Often askedUsually asked by the clinical director or clinical leadSAFER

    The nurse tells you a patient has received a medication meant for someone else. What do you do?

    Assess the patient for harm from the drug and treat it, tell your senior, complete the incident report, make sure the patient is told, and check the patient who was meant to receive it. Support the nurse. Say what the duty of candour requires and who has the conversation.

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